Randomised controlled trial of online vocational support for young people with mental ill health

The Youth Online Training and Employment System (#yotes), an online vocational support platform for young people with mental ill health. #yotes comprises a platform for the delivery of a range of vocational support strategies which are enhanced by a moderated online social networking environment. Importantly, #yotes adopts a strengths-based approach through which users are guided and prompted to identify, discuss and exercise key personal strengths within the online environment and in real-life to enhance self-esteem, foster social functioning and improve mental health. This approach is based on the novel positive psychology model which poses that psychosocial interventions should aim to build strengths, meaning and purpose as well as relieve symptoms. Specifically, #yotes integrates: i) peer-to-peer on-line social networking; ii) individually tailored interactive vocational support strategies; and (iii) expert vocational and peer moderation. Peer-to-peer online social networking (the ‘cafe’): the ‘cafe’ includes a web feed (or newsfeed) where participants and moderators can post comments, information, upload pictures and videos, and ‘like’ different content. The newsfeed organises discussion threads into relevant themes (e.g. ‘what’s on your mind’, ‘I’m loving right now’, ‘cheers me up’ etc.). Moreover the system includes a ‘wall’ function displaying the activity of individual users, and a ‘network’ (similar to a ‘friends’ function). Vocational support strategies (‘pathways’ and ‘steps’): #yotes includes vocational content developed using The Core Skills for Work Developmental Framework and delivered as a series of interactive ‘pathways and steps’. The pathways target key skills and behaviours across three domains of Core Skills for Work: navigating the world of work, interacting with others and getting the work done. This framework is recommended by the federal government and the Career Development Association of Australia. The pathways are divided into ‘step’ or modules. An example of a #yotes pathway is ‘Career planning’, which introduces the concept of a career as a process of continuous learning and development over the course of your life. The ‘Career planning’ pathway is comprised of three steps: ‘Interests, skills and values’, ‘career exploration’, and ‘making a career plan’. #yotes has the capacity to automatically suggest vocational content based on the participant's self-identified strengths/skills for work that the participant is encouraged to select in an activity at the beginning of their time on #yotes and that can be changed throughout. #yotes also houses a 'job zone' where local job and training opportunities will be updated and a moderated online problem solving function where issues nominated by users are discussed through structured phases following an evidence-based problem solving framework. Example of topics that may be discussed are ‘how to balance work and study’ or ‘how to manage disclosure of mental health in the workplace’. Offered solutions and users experiences are stored in a data-base serving as a ‘wiki’ for participants. Vocational Moderation: #yotes incorporates two types of moderation: Expert vocational moderation and peer vocational motivators. #yotes moderation has been informed by social cognitive theory and recent evidence from the computing and information systems field which posit that moderators’ can model appropriate online behaviours through demonstrating desired actions and behaviours. Expert vocational moderators will be expert vocational workers with significant experience in working with young people. Their role will be to provide guidance, monitor participant’s engagement with the system and ensure the safety of the social networking environment. Briefly, expert moderators will engage the participant in a conversation, initially by phone and then online, about their work and study goals. From there, expert moderators will suggest content from within #yotes based on the participant’s initial profile (e.g. age, level of education, working status) and their activity within the platform which is tracked by the system and accessible only by moderators in the back-end of #yotes. Other content suggested by expert moderators will be job vacancies. They will assist with the preparation of CVs, cover letters and other applications through the #yotes emailing facility. Moderators will ensure the safety of the social networking environment by reviewing all uploaded content for breaches of the #yotes terms of use as well as signs of deterioration in participant mental state. The system will be moderated daily during weekdays between the hours of 9am and 5pm. Moderators will be supervised weekly by senior vocational staff and clinicians from the research team. Peer vocational motivation: #yotes users will also be moderated by young people with a lived experience of mental ill health who have previously overcome disruption to their educational and vocational outcomes. Peer vocational motivators will provide guidance, information and emotional peer-to-peer support within the online environment to counteract self-stigma and foster empowerment. Their role will include assistance with the induction process upon entry into #yotes and support throughout their time on #yotes. Peer vocational motivators will receive regular supervision and guidance from the expert vocational moderators and research team as needed. #yotes is accessed through a closed website. Participant’s are advised they may use the site at their own discretion over the 6 month trial period. #yotes is programmed to capture all user activity that can be monitored in real time and will be used in analysis to measure participant engagement with the platform.